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Nevin Manimala Statistics

Diagnostic performance of MUAC and MUACZ in screening acute malnutrition among children aged 6-23 months in Amhara Region, Ethiopia

Sci Rep. 2025 Aug 4;15(1):28374. doi: 10.1038/s41598-024-82294-x.

ABSTRACT

Mid-Upper Arm Circumference (MUAC), Mid-Upper Arm Circumference-for-Age Z-Score (MUACZ), or Weight-for-Length Z-Score (WHZ) are used to screen for acute malnutrition in children. Studies conducted in various countries, including Ethiopia, have indicated variability in the agreement between these assessments at the World Health Organization recommended cutoffs across different ethnic groups with varying body frames. The low sensitivity of MUAC at standard cutoffs has important implications for program effectiveness. Therefore, this study aimed to validate the diagnostic performance of MUAC and MUACZ in screening for acute malnutrition among children aged 6-23 months in Ethiopia. A community-based cross-sectional study was conducted on 457 randomly selected children aged 6-23 months in the Amhara Region, Ethiopia, from February 2-18, 2023. The Spearman’s rank correlation test, Cohen’s kappa statistics, and Receiver Operating Curve analysis were conducted. The optimal cutoff points for MUAC and MUACZ were determined by selecting the points that maximized the Youden index. Statistical significance was determined with a p-value < 0.05, using a 95% confidence interval. MUAC, MUACZ, and WHZ results revealed that 11.0%, 8.6%, and 13.2% of children were wasted, respectively, and the percentage of misclassification in screening acute malnutrition was approximately 16%. MUAC and MUACZ had low sensitivity but high specificity in screening for acute malnutrition. MUAC and MUACZ showed poor correlation with WHZ when screening subjects for acute malnutrition using the World Health Organization standard cutoffs. In the Receiver Operating Characteristics curve analysis, significant predictive ability was only observed with MUAC when screening global acute malnutrition cases, and it showed a poor predictive ability (AUC = 0.61, 95% CI: 0.53, 0.70) (p < 0.001). The Youden index statistics revealed that the optimal cutoff for MUAC and MUACZ to define global acute malnutrition at WHZ < -2 SD was 13.6 cm and -0.43 SD, respectively. In addition, the optimal cutoffs for diagnosing severe acute malnutrition in children with WHZ of < -3 SD were found to be 13.1 cm and -1.91 SD for MUAC and MUACZ, respectively. The optimal cutoff values also vary in sex and age categories. Both MUAC and MUACZ had poor performance in screening acute malnutrition, and a significant proportion of children were missed despite they were wasted as compared to WHZ at the standard cutoffs. The optimal cutoff levels differ for different age and sex categories. This may affect admission and discharge rates and have a significant impact on children’s health. Modifications in the standard cutoffs are needed to ensure the quality of acute malnutrition screening and treatment services.

PMID:40760063 | DOI:10.1038/s41598-024-82294-x

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Nevin Manimala Statistics

Nutritional care in metastatic RCC: patient experiences and reported unaddressed needs

Support Care Cancer. 2025 Aug 4;33(8):754. doi: 10.1007/s00520-025-09801-2.

ABSTRACT

PURPOSE: Although renal cell carcinoma (RCC) presents unique nutritional challenges due to the disease itself and treatment side effects, little is known about the prevalence of nutritional issues among RCC patients in a real-world setting. This study aimed to investigate the patient-reported prevalence of nutritional issues and the response of healthcare teams to these challenges.

METHODS: A survey among RCC patients in Germany was developed in collaboration with patient organizations and included 46 questions covering demographics, nutritional issues, and cancer care experiences. It was distributed online from April to July 2022. Responses from 94 German RCC patients were analyzed using descriptive and inferential statistics.

RESULTS: Nutritional concerns were reported by 60.6% of participants, with diarrhea (23.4%), loss of appetite (21.3%), and nausea (20.2%) being the most common issues. Unintentional weight loss was reported by 49.4% of patients, but only 13.9% were referred to nutrition specialists. More than two-thirds reported a negative or extremely negative impact due to these problems on their physical condition and quality of life. Additionally, 67% of patients felt that their nutritional needs were not taken seriously by their healthcare teams. Most patients (84%) think that nutritional care should be part of routine cancer care.

CONCLUSION: The findings reveal significant gaps in the nutritional care of RCC patients. Screenings and proactive assessments do not appear to be performed as suggested by nutritional guidelines. Thus, nutritional counseling and support are obviously still not integrated into real-world comprehensive oncological care.

PMID:40760061 | DOI:10.1007/s00520-025-09801-2

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Nevin Manimala Statistics

Prevalence and impact of preoperative osteoporosis on healthcare utilization and patient-reported outcomes in primary total knee arthroplasty

Eur J Orthop Surg Traumatol. 2025 Aug 4;35(1):339. doi: 10.1007/s00590-025-04418-x.

ABSTRACT

PURPOSE: Osteoporosis is a well-recognized risk factor for complications after total knee arthroplasty (TKA). However, the effect of pre-TKA osteoporosis on healthcare utilization and patient-reported outcomes is poorly understood. Here, we characterize the association between pre-TKA osteoporosis and (1) healthcare utilization and patient-reported pain and function outcome measures; and (2) dual X-ray absorptiometry (DEXA) scan T-scores and the aforementioned outcomes.

METHODS: A prospective cohort of primary elective TKA patients between July 2015 and January 2020 was obtained (n = 6318), of which 4922 (77.9%) completed 1-year follow-up. Outcomes included healthcare utilization (prolonged length of stay (LOS) ≥ 3D, discharge disposition (DD), 90-day readmission, and 1-year reoperation) as well as Knee Injury and Osteoarthritis Outcome Score (KOOS) Pain, KOOS-function (PS) and satisfaction.

RESULTS: The prevalence of pre-TKA osteoporosis was 66.8%, of which 28.7% had a DEXA scan and 66.3% were on osteoporosis medications. Medicated osteoporotic patients were independently associated with higher odds of prolonged LOS (Odds Ratio (OR): 1.21 (95% Confidence Interval (CI) 1.02-1.43)) and non-home DD (OR:1.56 (95%CI 1.25-1.95)). Medicated and non-medicated osteoporosis patients were associated with higher odds of 90-day readmission. The odds of failing to achieve MCID or satisfaction were not associated with preoperative OP diagnosis.

CONCLUSION: Two-thirds of primary TKA recipients had osteoporosis. Among these patients, two-thirds were on medication and one-third had a DEXA scan. Osteoporotic patients are at a higher risk of 90-day hospital readmission, longer hospital stays and non-home discharge. Interestingly, osteoporosis status was not associated with failure to achieve clinically significant improvements or satisfaction at 1 year following TKA.

PMID:40760057 | DOI:10.1007/s00590-025-04418-x

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Nevin Manimala Statistics

Quantifying large language model usage in scientific papers

Nat Hum Behav. 2025 Aug 4. doi: 10.1038/s41562-025-02273-8. Online ahead of print.

ABSTRACT

Scientific publishing is the primary means of disseminating research findings. There has been speculation about how extensively large language models (LLMs) are being used in academic writing. Here we conduct a systematic analysis across 1,121,912 preprints and published papers from January 2020 to September 2024 on arXiv, bioRxiv and Nature portfolio journals, using a population-level framework based on word frequency shifts to estimate the prevalence of LLM-modified content over time. Our findings suggest a steady increase in LLM usage, with the largest and fastest growth estimated for computer science papers (up to 22%). By comparison, mathematics papers and the Nature portfolio showed lower evidence of LLM modification (up to 9%). LLM modification estimates were higher among papers from first authors who post preprints more frequently, papers in more crowded research areas and papers of shorter lengths. Our findings suggest that LLMs are being broadly used in scientific writing.

PMID:40760036 | DOI:10.1038/s41562-025-02273-8

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Nevin Manimala Statistics

fNIRS reproducibility varies with data quality, analysis pipelines, and researcher experience

Commun Biol. 2025 Aug 4;8(1):1149. doi: 10.1038/s42003-025-08412-1.

ABSTRACT

As data analysis pipelines grow more complex in brain imaging research, understanding how methodological choices affect results is essential for ensuring reproducibility and transparency. This is especially relevant for functional Near-Infrared Spectroscopy (fNIRS), a rapidly growing technique for assessing brain function in naturalistic settings and across the lifespan, yet one that still lacks standardized analysis approaches. In the fNIRS Reproducibility Study Hub (FRESH) initiative, we asked 38 research teams worldwide to independently analyze the same two fNIRS datasets. Despite using different pipelines, nearly 80% of teams agreed on group-level results, particularly when hypotheses were strongly supported by literature. Teams with higher self-reported analysis confidence, which correlated with years of fNIRS experience, showed greater agreement. At the individual level, agreement was lower but improved with better data quality. The main sources of variability were related to how poor-quality data were handled, how responses were modeled, and how statistical analyses were conducted. These findings suggest that while flexible analytical tools are valuable, clearer methodological and reporting standards could greatly enhance reproducibility. By identifying key drivers of variability, this study highlights current challenges and offers direction for improving transparency and reliability in fNIRS research.

PMID:40760004 | DOI:10.1038/s42003-025-08412-1

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Nevin Manimala Statistics

Palestinian students’ attitudes toward honor killing crimes: a quantitative, cross-sectional study

BMC Psychol. 2025 Aug 4;13(1):861. doi: 10.1186/s40359-025-03159-0.

ABSTRACT

BACKGROUND: Honor killings are a deeply ingrained practice within Palestinian patriarchal culture, where violations of perceived family honor-particularly by women-can lead to extreme consequences. This study examines the attitudes of Palestinian university students toward honor killings, with a focus on understanding how the younger, more educated generation perceives this phenomenon. Given the role of socialization and moral development in shaping beliefs, this research explores whether gender, geography, and religious background influence attitudes toward honor-based violence.

METHODS: A quantitative, cross-sectional survey was conducted among students at An-Najah National University, the largest university in the West Bank. A structured questionnaire, developed by the researchers, was distributed online to assess students’ attitudes toward honor killings, particularly concerning women’s marital status and involvement in perceived moral transgressions. Statistical analyses, including chi-square tests and logistic regression, were employed to examine associations between demographic factors (gender, geographical location, and religious affiliation) and students’ responses.

RESULTS: Findings revealed that while a significant portion of students justified the killing of individuals engaging in extramarital sexual relationships, they largely opposed violence against women who had non-sexual interactions with men. Gender differences were evident, with male students exhibiting stronger endorsement of honor-based violence compared to females. Psychological constructs such as moral disengagement and cognitive dissonance may play a role in justifying or rejecting honor killings, with religious and cultural influences further shaping these attitudes.

CONCLUSIONS: The study highlights the persistence of honor-based justifications for violence among segments of the younger generation, emphasizing the need for psychological and educational interventions. Addressing cognitive biases, reshaping social norms, and implementing policies that challenge gender-based violence are critical for fostering attitudinal change. The findings contribute to the broader discourse on honor crimes and gender equality in Palestinian society, offering insights for future research and policy development.

PMID:40759984 | DOI:10.1186/s40359-025-03159-0

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Nevin Manimala Statistics

Risk factor for gametocyte carriage and gametocytemia in Plasmodium vivax and Plasmodium falciparum

Infect Dis Poverty. 2025 Aug 4;14(1):79. doi: 10.1186/s40249-025-01352-2.

ABSTRACT

BACKGROUND: Understanding Plasmodium sexual differentiation is crucial for blocking transmission. This study identified risk factors for gametocyte carriage and gametocytemia in P. vivax and P. falciparum to inform malaria elimination strategies at the China-Myanmar border.

METHODS: Gametocytes and asexual parasites were microscopically detected on thick smears collected from 2011 to 2020 in Laiza Township, Kachin State, Myanmar. Mono-/polyclonality were detected by genotyping at Pvmsp3α/β for P. vivax, and Pfmsp1/2 for P. falciparum. Kulldorff’s retrospective time scan statistics tested for likely clusters of gametocyte-positive cases over time. Chi-square or Fisher’s exact tests compared proportions of gametocyte-positive cases in categorical variables. Generalized linear models assessed risk factors (year, season, demographics, clinical/parasitological features) for gametocyte carriage (logistic regression for a binomial outcome) and gametocytemia (Gaussian regression for continuous outcome), respectively.

RESULTS: During 2011-2020, 8240 patients had P. vivax infections, with 7249 testing positive for gametocytes. Among 510 P. falciparum cases, 56 tested positive for gametocytes. A significant cluster of P. vivax gametocyte carriage occurred from May 2015 to August 2017 (P = 0.001). For P. vivax, dry season, previous malaria history, fever, and parasite density were associated with gametocyte carriage. Gametocyte density increased with asexual parasite density (P < 0.001) but was lower during the rainy season and in those with a history of malaria infection (P < 0.001). Over time, gametocytes carriage proportion increased while density decreased (P < 0.001). For P. falciparum, younger age and previous malaria history were associated with gametocyte carriage, and density was higher in the dry season (P = 0.0115). Polyclonal P. vivax infections had higher gametocyte densities than monoclonal infections (P < 0.0001) and P. falciparum gametocyte density tended to increase with multiplicity of infection.

CONCLUSIONS: Younger age, prior malaria infection, travel, and polyclonal infections correlate with higher P. vivax gametocyte prevalence. Gametocyte carriage peakes during the dry season, highlighting the need for seasonal strategies to support malaria elimination. These findings enhance understanding of risk factors for the transmissible stage of the two main human Plasmodium species in the Greater Mekong Subregion border areas.

PMID:40759976 | DOI:10.1186/s40249-025-01352-2

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Predictive value of the combined triglyceride-glucose and frailty index for cardiovascular disease and stroke in two prospective cohorts

Cardiovasc Diabetol. 2025 Aug 4;24(1):318. doi: 10.1186/s12933-025-02880-9.

ABSTRACT

BACKGROUND: The triglyceride-glucose (TyG) index is a validated surrogate for insulin resistance, while frailty reflects cumulative physiological decline. The combined impact of TyG-Frailty Index (TyGFI) has not been adequately explored. This study aimed to investigate the association between TyGFI and the risk of cardiovascular disease (CVD) and stroke.

METHODS: A total of 5448 participants from the China Health and Retirement Longitudinal Study (CHARLS) and 1139 participants from the U.S. National Health and Nutrition Examination Survey (NHANES) were included. Multivariable logistic regression models were used to estimate associations with CVD and stroke, adjusting for demographic, clinical, and lifestyle covariates. Restricted cubic spline (RCS) and subgroup analyses were employed to examine dose-response relationships and interaction effects.

RESULTS: Higher TyGFI levels were associated with older age, adverse metabolic parameters, and increased prevalence of hypertension, diabetes, and dyslipidemia. In fully adjusted models, the highest TyGFI quartile was significantly associated with increased risks of CVD (CHARLS: OR 15.09, 95% CI 9.65-23.60; NHANES: OR 4.98, 95% CI 2.04-12.19) and stroke (CHARLS: OR 21.12, 95% CI 6.44-69.23; NHANES: OR 12.98, 95% CI 2.58-65.17), with consistent dose-response trends confirmed by RCS analyses. Subgroup analyses further demonstrated the robustness of these associations across diverse demographic and clinical strata.

CONCLUSIONS: TyGFI is a strong and independent predictor of CVD and stroke in two nationally representative cohorts. By integrating metabolic and functional risk dimensions, TyGFI provides a more comprehensive risk stratification tool, with significant implications for early identification and prevention of cardiovascular events in aging populations.

PMID:40759963 | DOI:10.1186/s12933-025-02880-9

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Nevin Manimala Statistics

Biophysical and biochemical signatures of pancreatic stellate cell activation: insights into mechano-metabolic signalling from atomic force microscopy and Raman spectroscopy

Cell Commun Signal. 2025 Aug 4;23(1):363. doi: 10.1186/s12964-025-02354-1.

ABSTRACT

BACKGROUND: Pancreatic fibrosis is a key pathological feature of chronic pancreatitis and pancreatic cancer, driven by the persistent activation of pancreatic stellate cells. These cells, normally quiescent, undergo profound phenotypic changes in response to environmental cues, yet the interplay between mechanical forces and metabolic reprogramming during this transition remains poorly understood. As the stromal microenvironment actively communicates with epithelial and vascular compartments, understanding this mechano-metabolic signalling axis is critical for uncovering novel mechanisms of tissue remodelling.

METHODS: To investigate the biomechanical and biochemical alterations during stellate cell activation, we employed atomic force microscopy and Raman spectroscopy to measure changes in cell stiffness, morphology, and molecular composition. These data were complemented by transcriptomic analyses to evaluate gene expression profiles related to lipid metabolism and autophagy. Quantitative statistical tests, including ANOVA and Kruskal-Wallis tests with appropriate post hoc corrections, were applied.

RESULTS: Activation of human pancreatic stellate cells led to progressive cytoskeletal remodelling, increased cellular stiffness, and a flattened morphology. Raman spectroscopy revealed an expansion of the cytoplasmic area, changes in nucleic acid signal, and significant increases in lipid content, particularly in unsaturated lipids and triacylglycerols. Gene expression analysis demonstrated upregulation of lipid elongation and desaturation pathways, along with enhanced autophagy, suggesting a coordinated metabolic adaptation. These changes support the myofibroblast-like phenotype and may influence intercellular signalling by altering extracellular matrix composition, mechanical tension, and the release of signalling molecules that affect the surrounding microenvironment.

CONCLUSIONS: Our findings reveal that pancreatic stellate cell activation involves a tightly coupled shift in mechanical and metabolic states, highlighting an integrated signalling process that may modulate stromal-vascular and stromal-epithelial communication. This mechano-metabolic axis represents a potential therapeutic target in fibrotic and neoplastic pancreatic diseases, where aberrant stromal signalling contributes to disease progression.

PMID:40759959 | DOI:10.1186/s12964-025-02354-1

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Nevin Manimala Statistics

Could carotid artery calcifications and pulp stones be an alarm sign for diabetes mellitus? A retrospective observational study

BMC Endocr Disord. 2025 Aug 4;25(1):191. doi: 10.1186/s12902-025-02005-z.

ABSTRACT

BACKGROUND: Carotid artery calcifications and pulpal stones are radiopaque findings that may be found accidentally in panoramic views. The risk of affliction with atherosclerotic events in diabetic patients with dystrophic calcification is questionable. This study aimed to investigate the relative frequency of carotid calcifications and pulp stones in panoramic radiographs of diabetic patients.

METHODS: This retrospective observational study employed a convenience sampling method involving 107 diabetic patients. For comparison, 300 panoramic views from individuals estimated to be healthy in the community were included. The samples were randomly selected from the statistical population using a random numbers table. Data analysis was conducted using descriptive statistics, including mean and standard deviation, as well as analytical tests such as the chi-square test, all performed with SPSS 17 software (Chicago, USA).

RESULTS: In this study, panoramic radiographs of 107 diabetic patients (67 women and 40 men) and 300 healthy individuals (196 women and 104 men) were evaluated. The age range was 25 to 64 years, with a mean age of 49.7. The frequency of carotid artery calcification was 42 (14%) in healthy individuals and 44 (41.1%) in diabetic patients. Furthermore, the relative frequency of unilateral and bilateral carotid artery calcification in diabetic patients was significantly higher than in healthy subjects (P < 0.05). The Relative Risk (RR) of pulp stones in the diabetic patient group compared to healthy individuals was 1.8. With a 95% confidence interval, the relative risk ranged from 1.3 to 2.48, which was statistically significant (P < 0.05).

CONCLUSIONS: Based on the findings, the frequency of carotid artery calcification and pulp stones was higher in diabetic patients. Panoramic radiographic screening in diabetic patients is useful for early detection of carotid artery calcification and timely referral of patients to endocrinologists to prevent adverse sequelae.

PMID:40759953 | DOI:10.1186/s12902-025-02005-z